TY - JOUR
T1 - Optical coherence tomography angiography for identifying choroidal neovascular membranes
T2 - a masked study in clinical practice
AU - Ghanchi, Faruque D
AU - Fulcher, Corinne
AU - Madanat, Zeid
AU - Mdanat, Faris
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - BACKGROUND/OBJECTIVES: Optical coherence tomography angiography (OCT-A) allows non-invasive imaging of chorio-retinal vasculature, and is a potential alternative to fluorescein angiography (FA). Sensitivity and specificity of OCT-A for detecting choroidal neovascularisation (CNV) in treatment-naïve neovascular age-related macular degeneration (nAMD) patients is examined, using the Heidelberg Spectralis in a 'real world' setting.SUBJECT/METHODS: Overall, 43 eyes from 26 patients were included in the study. Spectral domain OCT (SD-OCT), OCT-A and FA images were obtained at baseline. Each of the three retinal image modalities was systematically assessed by three masked clinicians. Decisions about the presence/absence of CNV were recorded using an automated segmentation for OCT-A, a manual method, and using both OCT-A and SD-OCT in conjunction. Additional information about the presence of sub-retinal hyper-reflective material (SHRM) and the 'double layer sign' (DLS) were recorded.RESULTS: The average sensitivity and specificity of the OCT-A for the detection of CNV in treatment naïve AMD was 89% and 87% for the combined SD-OCT and OCT-A, 76% and 91% for the automated segmentation and 84% and 85% for the manual segmentation, respectively. Inter-clinician agreement was 0.59-65 kappa. In patients without CNV, SHRM was present in only 6% while DLS was present in 28%. Sensitivity and specificity was >78% for both SHRM and DLS.CONCLUSIONS: OCT-A provides a reliable tool for detecting CNV in treatment naïve nAMD patients, with high sensitivity and specificity. Combined use of SD-OCT images and SHRM as an additional bio-marker, OCT-A could become an alternative to FA in routine clinical practice.
AB - BACKGROUND/OBJECTIVES: Optical coherence tomography angiography (OCT-A) allows non-invasive imaging of chorio-retinal vasculature, and is a potential alternative to fluorescein angiography (FA). Sensitivity and specificity of OCT-A for detecting choroidal neovascularisation (CNV) in treatment-naïve neovascular age-related macular degeneration (nAMD) patients is examined, using the Heidelberg Spectralis in a 'real world' setting.SUBJECT/METHODS: Overall, 43 eyes from 26 patients were included in the study. Spectral domain OCT (SD-OCT), OCT-A and FA images were obtained at baseline. Each of the three retinal image modalities was systematically assessed by three masked clinicians. Decisions about the presence/absence of CNV were recorded using an automated segmentation for OCT-A, a manual method, and using both OCT-A and SD-OCT in conjunction. Additional information about the presence of sub-retinal hyper-reflective material (SHRM) and the 'double layer sign' (DLS) were recorded.RESULTS: The average sensitivity and specificity of the OCT-A for the detection of CNV in treatment naïve AMD was 89% and 87% for the combined SD-OCT and OCT-A, 76% and 91% for the automated segmentation and 84% and 85% for the manual segmentation, respectively. Inter-clinician agreement was 0.59-65 kappa. In patients without CNV, SHRM was present in only 6% while DLS was present in 28%. Sensitivity and specificity was >78% for both SHRM and DLS.CONCLUSIONS: OCT-A provides a reliable tool for detecting CNV in treatment naïve nAMD patients, with high sensitivity and specificity. Combined use of SD-OCT images and SHRM as an additional bio-marker, OCT-A could become an alternative to FA in routine clinical practice.
KW - Choroidal neovascular membranes
KW - Optical coherence tomography angiography (OCT-A)
UR - http://www.scopus.com/inward/record.url?scp=85096499074&partnerID=8YFLogxK
U2 - 10.1038/s41433-020-01285-0
DO - 10.1038/s41433-020-01285-0
M3 - Article
C2 - 33235335
VL - 35
SP - 134
EP - 141
JO - Transactions of the Ophthalmological Societies of the United Kingdom
JF - Transactions of the Ophthalmological Societies of the United Kingdom
SN - 0950-222X
IS - 1
ER -